PSC 432 Chapter 35: Antifungal drugs
17 Feb 2019
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Renal impairment, anemia (normochromic, normocytic), and thrombophlebitis: a shocklike fall in blood pressure accompanied by hypokalemia may occur, requiring potassium supplementation, serious neurologic problems with intrathecal administration. Azoles: triazoles: fluconazole, itraconazole (flucit, moa; block conversion of lanosterol to ergosterol by inhibiting fungal cytochrome p450 dependent 14-alpha-demethylase. This disrupts membrane structure and function and thereby inhibits fungal growth, so, fungistatic. Interactions; inhibit cyp (those that are administered systemically: ci; pregnancy, ketoconazole, use;mucocutaneous candidiasis and dermatophytosis (replaced in most mycoses by itraconazole, pharmacokinetics; administered orally. Does not enter csf: ae; gi disturbances, hepatotoxicity, infertility, gynecomastia and menstrual irregularity (results from blocking of androgen and adrenal steroid synthesis) Interactions; miconazole is a potent inhibitor of warfarin metabolism, and has resulted in bleeding in warfarin treated patients even when applied topically. Flucytosine (5-fc: moa; pyrimidine antimetabolite, converted to 5-fu (5-fluorodeoxyuridine 5"-monophosphate), a false nucleotide that inhibits thymidylate synthase, depriving the organism of thymidylic acid an essential dna component.
